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Proton magnetic resonance spectroscopy and outcome in term neonates with chorioamnionitis.

Johnson CB, Jenkins DD, Bentzley JP, Lambert D, Hope K, Rollins LG, Morgan PS, Brown T, Ramakrishnan V, Mulvihill DM, Katikaneni LD - J Perinatol (2015)

Bottom Line: Infants with below average outcomes did not show the same increase in NAA/Cho ratios postnatally as the group with normal outcomes.In males, increased lactate/NAA in BG were associated with lower motor scores.Funisitis severity was associated with decreased NAA/Cho and increased mI/NAA in males.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience's Center for Advanced Imaging Research, Medical University of South Carolina, Charleston, SC, USA.

ABSTRACT

Objective: Evaluate brain metabolites, which reflect neuroinflammation, and relate to neurodevelopmental outcomes in healthy term neonates exposed to chorioamnionitis.

Study design: Thirty-one healthy term neonates with documented fetal inflammatory response after maternal chorioamnionitis underwent magnetic resonance spectroscopy (MRS), with voxels placed in basal ganglia (BG) and frontal white matter. Bayley III examinations were performed at 12 months of age.

Result: Infants with below average outcomes did not show the same increase in NAA/Cho ratios postnatally as the group with normal outcomes. Decreased NAA/Cho and increased Lac/Cr in BG correlated with lower motor and cognitive composite scores, respectively, controlling for postnatal age. In males, increased lactate/NAA in BG were associated with lower motor scores. Funisitis severity was associated with decreased NAA/Cho and increased mI/NAA in males.

Conclusion: In healthy term newborns with chorioamnionitis, MRS ratios shortly after birth may provide evidence of occult neuroinflammation, which may be associated with worse performance on 1-year neurodevelopmental tests.

No MeSH data available.


Related in: MedlinePlus

Regression plots of Lac/Cr metabolite ratios compared with 12-month Bayley III scores. (a) In males, Lac/Cr ratios in basal ganglia (BG) correlate significantly with gross motor domain scores. (b) In females, Lac/Cr ratios in white matter (WM) correlate significantly with fine motor domain scores. (c) In males, Lac/Cr in BG correlate significantly with cognitive composite scores. Data points represent raw data on individual patients.
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fig5: Regression plots of Lac/Cr metabolite ratios compared with 12-month Bayley III scores. (a) In males, Lac/Cr ratios in basal ganglia (BG) correlate significantly with gross motor domain scores. (b) In females, Lac/Cr ratios in white matter (WM) correlate significantly with fine motor domain scores. (c) In males, Lac/Cr in BG correlate significantly with cognitive composite scores. Data points represent raw data on individual patients.

Mentions: Although sex did not have a significant effect on MRS metabolite ratios overall, sex was a significant factor in the model for association of lactate ratios with gross and fine motor scores, controlling for PNA (Figure 5). In females, lactate ratios in WM were negatively associated with fine motor scores (n=8, Lac/NAA: r=−0.745, P=0.043, Figure 5b; Lac/Cr: r=−0.424, P=0.038). In males, Lac/NAA ratio in the BG had a strong association with gross motor scores and motor composite at 12 months (n=9, Lac/NAA and gross motor: r=−0.856, P=0.007, Figure 5a; Lac/Cr and gross motor: r=−0.799, P=0.031; Lac/NAA and motor composite: r=−0.755, P=0.024). Lac/NAA ratios remain significantly negatively associated with gross motor scores in males, even after correction for multiple comparisons testing of seven metabolite ratios. Lac/NAA ratios in the BG combine two strong indicators of neuroinflammation and maturation, and have been shown to be among the best predictors of 18-month outcome after neuroinflammation because of hypoxic ischemic injury.17 In our cohort exposed to chorioamnionitis, Lac/NAA ratios in the BG are also strongly associated with motor outcomes, but reflect the interaction of neuroinflammation because of chorioamnionitis and male sex on motor outcomes.


Proton magnetic resonance spectroscopy and outcome in term neonates with chorioamnionitis.

Johnson CB, Jenkins DD, Bentzley JP, Lambert D, Hope K, Rollins LG, Morgan PS, Brown T, Ramakrishnan V, Mulvihill DM, Katikaneni LD - J Perinatol (2015)

Regression plots of Lac/Cr metabolite ratios compared with 12-month Bayley III scores. (a) In males, Lac/Cr ratios in basal ganglia (BG) correlate significantly with gross motor domain scores. (b) In females, Lac/Cr ratios in white matter (WM) correlate significantly with fine motor domain scores. (c) In males, Lac/Cr in BG correlate significantly with cognitive composite scores. Data points represent raw data on individual patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660057&req=5

fig5: Regression plots of Lac/Cr metabolite ratios compared with 12-month Bayley III scores. (a) In males, Lac/Cr ratios in basal ganglia (BG) correlate significantly with gross motor domain scores. (b) In females, Lac/Cr ratios in white matter (WM) correlate significantly with fine motor domain scores. (c) In males, Lac/Cr in BG correlate significantly with cognitive composite scores. Data points represent raw data on individual patients.
Mentions: Although sex did not have a significant effect on MRS metabolite ratios overall, sex was a significant factor in the model for association of lactate ratios with gross and fine motor scores, controlling for PNA (Figure 5). In females, lactate ratios in WM were negatively associated with fine motor scores (n=8, Lac/NAA: r=−0.745, P=0.043, Figure 5b; Lac/Cr: r=−0.424, P=0.038). In males, Lac/NAA ratio in the BG had a strong association with gross motor scores and motor composite at 12 months (n=9, Lac/NAA and gross motor: r=−0.856, P=0.007, Figure 5a; Lac/Cr and gross motor: r=−0.799, P=0.031; Lac/NAA and motor composite: r=−0.755, P=0.024). Lac/NAA ratios remain significantly negatively associated with gross motor scores in males, even after correction for multiple comparisons testing of seven metabolite ratios. Lac/NAA ratios in the BG combine two strong indicators of neuroinflammation and maturation, and have been shown to be among the best predictors of 18-month outcome after neuroinflammation because of hypoxic ischemic injury.17 In our cohort exposed to chorioamnionitis, Lac/NAA ratios in the BG are also strongly associated with motor outcomes, but reflect the interaction of neuroinflammation because of chorioamnionitis and male sex on motor outcomes.

Bottom Line: Infants with below average outcomes did not show the same increase in NAA/Cho ratios postnatally as the group with normal outcomes.In males, increased lactate/NAA in BG were associated with lower motor scores.Funisitis severity was associated with decreased NAA/Cho and increased mI/NAA in males.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience's Center for Advanced Imaging Research, Medical University of South Carolina, Charleston, SC, USA.

ABSTRACT

Objective: Evaluate brain metabolites, which reflect neuroinflammation, and relate to neurodevelopmental outcomes in healthy term neonates exposed to chorioamnionitis.

Study design: Thirty-one healthy term neonates with documented fetal inflammatory response after maternal chorioamnionitis underwent magnetic resonance spectroscopy (MRS), with voxels placed in basal ganglia (BG) and frontal white matter. Bayley III examinations were performed at 12 months of age.

Result: Infants with below average outcomes did not show the same increase in NAA/Cho ratios postnatally as the group with normal outcomes. Decreased NAA/Cho and increased Lac/Cr in BG correlated with lower motor and cognitive composite scores, respectively, controlling for postnatal age. In males, increased lactate/NAA in BG were associated with lower motor scores. Funisitis severity was associated with decreased NAA/Cho and increased mI/NAA in males.

Conclusion: In healthy term newborns with chorioamnionitis, MRS ratios shortly after birth may provide evidence of occult neuroinflammation, which may be associated with worse performance on 1-year neurodevelopmental tests.

No MeSH data available.


Related in: MedlinePlus